Objective To observe the expression of Her-2/neu protein and androgen receptor (AR) in human prostate cancer and to evaluate their significances in the progression of prostate cancer. Methods The Her-2/neu protein and AR immunohistochemical stain were carried out in human prostate tissue microarray that consisted of prostate cancer (107 cases) and benign prostate tissue (42 cases). The prostate cancer cases were divided into 4 groups: group one (Gleason score 6),group two (Gleasonscore 7), group three (Gleasonscore 8) and group four (Gleasonscore 9) according to the Gleason score. The immunostains immunohistochemical stain were interpreted in two aspects of the staining intensity and the percentage of positive cells. The significance and relationships between the expression of Her-2/neu protein and AR in prostate cancer and benign prostate tissue (BPT) and the grouping of different Gleason scores of prostate cancer were then evaluated. Results The positive expression rate of Her-2/neu protein was significantly higher in prostate cancer tissue than in BPT [43.9%(47/107) vs. 14.3%(6/42), x2=11.562, P=0.009], and the positive expression intensity of Her-2/neu immunoreactivity was also higher (x2= 11.764, P=0.008). There were significant differences in positive expression intensity of Her-2/neu immunoreactivity among the different Gleason scores groups (x2 = 20. 512, P = 0. 015), and the expression intensity was significantly positively correlated with Gleason scores ( r= 0. 269, P = 0. 005). There was significant difference in AR immunoreactivity between in prostate cancer (67 %, 72/107) and in BPT (50 %, 21/42, x2 =3. 843, P=0. 050). Among prostate cancer cases, the positive expression intensity of AR was not significantly different among groups 1 through 4 (x2 = 4. 318, P = 0. 229), and was not significantly correlated with Gleason scores ( r = - 0. 065, P = 0. 505 ). Moreover, the positive expression intensity of Her-2/neu protein was not significantly correlated with that of AR (r = -0. 115, P=0. 237). Conclusions Overexpression of Her-2/neu protein in human prostate cancer tissue suggests that Her-2/neu may have some role in prostate tumorigenesis. Her-2/neu protein expression is positively correlated with Gleason score in prostate cancer, which suggests that Her-2/neu may be a potential prognostic predictor of prostate cancer.

Objective To explore the effect of anoxic microenvironment and hypoxia related microRNA-210 (miR-210) on the epithelial-mesenchymal transition (EMT) in gastric cancer cell line 803.Methods The mRNA relative expressions of E-cadherin and Twist1 were detected by qRT-PCR in gastric cancer cell line after being induced hypoxia by CoCl2 (100,200 and 300 μ mol/L),which was compared with normoxic group (0 mol/L).The cell proliferation of gastric cancer cell line was observed by cell proliferation assay.The relative expressions of E-cadherin and Twist 1 were detected in gastric cancer cell line after transfecting miR-210 mimics.Results With the increase of the concentrations of CoCl2,the relative expression of miR-210 and the proliferation rate of gastric cancer cells showed a tendency of increase first and then decrease (P ＜ 0.05).The relative expression of E-cadherin mRNA was lower in hypoxia group than that of normoxic group.The relative expression of Twist1 mRNA was higher in hypoxia group than that of normoxic group.The relative expressions of Ecadherin mRNA were significantly higher in 200 and 300 μ mol/L CoCl2 groups than that of 100 μmol/L CoCl2 group (P ＜0.05).There was no significant difference in the relative expression of Twist1 mRNA between the three CoCl2 groups.The relative expression of Twist1 mRNA was higher in the transfection group than that of control group.The relative expression of E-cadherin mRNA was significantly lower in the transfection group than that of control group (P ＜ 0.05).Conclusion Hypoxia can promote the proliferation and EMT of gastric cancer cells.The up-regulation of miR-210 can also promote the procession of EMT,which may be the intermediate link in the process of EMT induced by hypoxia.

OBJECTIVE:To study the effects of spirulina kinase(SPK)on the vascular endothelial function of model rats with atherosclerosis. METHODS:60 rats were randomly divided into normal control group(distilled water),model group(distilled wa-ter),positive control group(simvastatin,0.005 g/kg)and SPK low-dose,medium-dose,high-dose groups(80,160,320 U/kg). Except for normal control group,rats in other groups were induced for model of atherosclerosis. All groups were intragastrically ad-ministrated relevant medicines at the same time,once a day for consecutive 12 weeks. Total cholesterol(TC),triglyceride(TG), low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) contents in serum of rats were measured. And the changes of thoracic aortic endothelium morphology were ob-served by HE staining. RESULTS:Compared with normal control group,TC,TG,LDL-C,IL-6,TNF-α contents in serum of rats in model group were increased(P<0.01),HDL-C content in serum was decreased(P<0.01);vascular endothelial cells fell off, intimal proliferation projected into the lumen,smooth muscle cell proliferated and disordered,medium film elastic fiber disintegrat-ed and fractured. Compared with model group,TC,TG,LDL-C,IL-6,TNF-α contents in serum of rats in administration groups were decreased(P<0.05 or P<0.01),HDL-C content in positive control group and SPK medium-dose,high-dose groups was in-creased (P<0.05). Vascular endothelial cell morphology was improved significantly in administration groups,in which,vascular endothelial cells were structurally intact in SPK medium-dose,high-dose groups,inner membrane was basically smooth;medium smooth muscle cells arranged slightly disordered in SPK medium-dose group. Compared with normal control group,there were no obvious changes. CONCLUSIONS:SPK shows obvious lipid-lowering and anti-inflammatory effects,it can protect vascular endo-thelial function. The mechanism may be related to reducing TC,TG,LDL-C,HDL-C,IL-6,TNF-αcontents and increasing HDL-C content in serum.

Objective:To evaluate the anesthetic effect of remazolam when combined with sufentanil in elderly patients with liver cirrhosis and esophageal and gastric varices undergoing endoscopic sclerotherapy.Methods:A total of 150 cirrhotic patients with liver cirrhosis and esophageal and gastric varices, regardless of gender, aged 65-80 yr, with body mass index of 18-24 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱor Ⅲ, who underwent endoscopic sclerotherapy under non-intubated general anesthesia from March 2022 to September 2023 in our hospital, were selected and divided into 2 groups ( n=75 each) by a random number table method: sufentanil plus propofol group (PS group) and sufentanil plus remazolam group (RS group). Anesthesia was induced with intravenous propofol 1-2 mg/kg and sufentanil 0.1 μg/kg and maintained by intravenous infusion of propofol 4-10 mg·kg -1·h -1 in PS group. Anesthesia was induced with intravenous remimazolam 0.1-0.2 mg/kg and sufentanil 0.1 μg/kg and was maintained with intravenous infusion of remimazolam 0.5-2.0 mg·kg -1·h -1 in RS group. BIS values were maintained between 40 and 60 during operation in both groups. Endoscopy was placed when the patients lost consciousness (modified observer′s assessment of alertness/sedation score ≤1). Sclerosing agent laurosinol injection was injected into esophageal submucosal varices in both groups. The time to loss of consciousness and recovery of consciousness, intraoperative body movement and cardiovascular events, and postoperative hypoxemia and nausea and vomiting were recorded. The operator-patient satisfaction was assessed by the visual analogue scale. Results:Compared with PS group, no significant changes were found in the incidence of intraoperative bradycardia, time to loss of consciousness and time to recovery of consciousness( P>0.05), the incidence of intraoperative hypotension was significantly decreased, the incidence of postoperative hypoxemia and nausea and vomiting was decreased, and the satisfaction scores for operators and patients were increased in RS group ( P<0.05). No obvious body movement was found in the two groups. Conclusions:Sufentanil combined with remifentanil provides better anesthetic effect than sufentanil combined with propofol in elderly patients with esophageal and gastric varices undergoing endoscopic sclerotherapy.

Obesity can not only lead to various metabolic diseases such as non-alcoholic fatty liver, hypertension, hyperlipidemia, diabetes, and cardiovascular disease, it is also closely related to the occurrence and development of heart failure. Heart transplantation is the ultimate treatment for patients with heart failure. However, heart failure patients with obesity are usually excluded from the list of heart transplants. That is to say, obesity is considered a contraindication for heart transplantation. The traditional weight loss methods, including lifestyle interventions and medications, can not effectively alleviate obesity and its comorbidities because of their limited effect and time-consuming. In addition, weight-loss drugs cannot be used in heart transplantation because they can affect the absorption of immunosuppressive drugs. At present, metabolic surgery has become the most effective method for the treatment of obesity and its comorbidities, and is now gradually applied in the field of heart transplantation most of the heart failure patients with obesity meet the standards of heart transplantation after metabolic surgery, greatly increasing the transplantation rate as well as obesity, obesity-related metabolic diseases, and cardiac function were significantly improved, even some patients with heart failure no longer need heart transplantation after their cardiac function has been significantly improved. However, the application of metabolic surgery in the field of heart transplantation has not yet reached a consensus, and only a few reviews on this topic have been published. In this article, the application status and prospects of metabolic surgery in the field of heart transplantation are reviewed so as to provided reference for clinical practice.

Objective:To investigate the clinical outcome and influencing factor of one-anastomosis duodenal switch (OADS) for obesity.Methods:The retrospective cohort study was conducted. The clinical data of 104 obesity patients who underwent OADS in the China-Japan Union Hospital of Jilin University from October 2018 to June 2021 were collected. There were 42 males and 62 females, aged 33(range, 18?66)years. The clinical outcome of each patient was evaluated using Textbook Outcome (TO). Observation indicators: (1) treatment situations for patients; (2) TO situa-tions; (3) analysis of factors affecting postoperative TO. Follow-up was conducted using outpatient examination or telephone interview to detect postoperative complication of patients up to November 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using chi-square test. Multivariate analysis was conducted using the binary Logistic regression model. Results:(1) Treatment situations for patients. All 104 patients under-went OADS without conversion to laparotomy or death of patient. The operation time and duration of postoperative hospital stay of the 104 patients were (187±39)minutes and 6(range, 4?55)days, respectively. Two of the 104 patients were readmitted. The experiences of surgeons on OADS was (53±30)cases. There were 82 patients underwent OADS using the Da Vinci robotic surgical system, while there were 22 patients underwent OADS using laparoscopic surgery system. The complication rate of 104 patients was 7.69%(8/104). Cases with stage Ⅱ, stage Ⅲb and stage Ⅳ complications of the Clavien Dindo classification were 5, 2 and 1, respectively. (2) TO situation. Of the 104 patients, 62 cases achieved TO, while 42 cases did not achieve TO. The operation time, retention time of abdominal drainage tube, duration of postoperative hospital stay, experiences of surgeons on OADS, number of OADS for surgeons using Da Vinci robotic surgical system were (166±26)minutes, 0(range, 0?7)days, 6(range, 4?7)days, 62±28, 54 in patients achieved TO, versus (218±34)minutes, 3 (range, 0?11)days, 8(range, 5?55)days, 38±27, 28 in patients not achieved TO, showing significant differences in the above indicators between them ( t=?8.81, Z=?3.63, ?5.33, t=4.27, χ2=6.27, P<0.05). Cases with complications were 0 in patients achieved TO, versus 8 in patients not achieved TO, showing a significant difference between them ( P<0.05). (3) Analysis of factors affecting postoperative TO. Results of multivariate analysis showed that the experiences of surgeons on OADS was an independent influencing factor for postoperative TO in patients undergoing OADS ( odds ratio=1.04, 95% confidence interval as 1.01?1.06, P<0.05). Conclusions:OADS is safe and feasible for obesity patients with low postoperative complication incidence and satisfactory clinical outcome. The experiences of surgeons on OADS is an independent influencing factor for postoperative TO in patients undergoing OADS.

Objective:To investigate the diagnostic efficacy of MRI-based or CT-based measurements and the combined evaluation methods for preoperative bone quality assessment in patients with cervical degenerative diseases.Methods:Patients who underwent spine surgery for cervical degenerative diseases at the Department of Orthopedics, Huashan Hospital, Fudan University from September 2020 to March 2022 with available preoperative X-ray, CT, MRI and dule energy X-Ray absorptiometry (DEXA) data were included in this study. Vertebral bone quality score (VBQ) based on MRI T1-weightedimages and CT Hounsfiled unit (HU) values of the cervical spine were measured, and a combined diagnostic formula based on the binary logistic regression was constructed. The patients were divided into normal bone mass (T≥-1.0) and osteopenia/osteoporosis groups (T<-1.0). The student's t-test and Chi-square test were performed for comparisons between groups. The Pearson correlation coefficient was also used to investigate the correlation between DEXA-T scores, cervical VBQ and CT HU values. In addition, receiver operating characteristic curve (ROC) were plotted to explore the diagnostic efficacy of VBQ, CT HU and their combined diagnosis. Meanwhile, the corresponding sensitivity and specificity were obtained. Results:A total of 71 patients were included in this study (17 in the normal group and 54 in the osteopenia/osteoporosis group). The student's t-test showed that VBQ (2.90±0.70 vs. 3.83±0.83, t=4.23, P<0.001) and CT HU values (370.26±85.38 vs. 295.20±67.96, t=3.73, P=0.002) were significantly different between the two groups. The area under the ROC curve (AUC) for VBQ and CT values of the cervical spine were 0.81 and 0.75, respectively, and the AUC for the combined diagnostic value constructed on the basis of both was 0.85. Applying VBQ scores alone had a diagnostic sensitivity of 80% and a specificity of 70%, and the combined diagnosis with VBQ and CT HU had a sensitivity of 90% and a specificity of 75%. Person correlation analysis showed a significant correlation between DEXA T value, cervical VBQ value and CT HU value. The detailed formula was: DEXA T score=-0.63×cervical VBQ+0.64 ( r=-0.55, P<0.001), CT HU value=-40.20×cervical VBQ+458.40 ( r=-0.45, P<0.001), DEXA T score=0.006×CT HU-3.47 ( r=0.45, P<0.001). Conclusion:This study confirmed the feasibility of using cervical VBQ values, CT HU values and combined diagnostics for preoperative bone density screening in patients with degenerative cervical spine diseases. This method allows surgeons to perform an initial preoperative bone density screening based on the patient's existing imaging data, and thus could aid in confirming the indication and scheme of surgery. The method could be a powerful tool for preoperative bone density assessment screening in patients with cervical degenerative diseases.